Our current understanding of checkpoint inhibitor therapy in cancer immunotherapy.

Our current understanding of checkpoint inhibitor therapy in cancer immunotherapy.
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我们目前对癌症免疫治疗中检查点抑制剂治疗的理解。

DOI:
10.1016/j.anai.2021.03.003
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发表时间:
2021-06
期刊:
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
影响因子:
--
通讯作者:
Kern JA
Kern JA
中科院分区:
其他
文献类型:
--
作者:
Goleva E;Lyubchenko T;Kraehenbuehl L;Lacouture ME;Leung DYM;Kern JA

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使用fda批准的靶向抑制性细胞毒性T淋巴细胞抗原4 (CTLA4)、程序性细胞死亡蛋白1 (PD-1)受体或程序性细胞死亡配体1 (PD-L1)的阻断抗体进行治疗,统称为检查点抑制剂(CPI),已经成功地产生了持久的缓解,即使在晚期癌症患者中也是如此。然而,这些治疗通常伴随着不良的自身免疫和炎症副作用,有时会给患者带来严重的后果。临床应用的快速扩展需要对CPI在健康和疾病中的功能有更细致的了解,以制定新的策略,以尽量减少负面副作用,同时保持免疫治疗的益处。本文综述了一种新的癌症免疫治疗范式转变方法,重点介绍了免疫检查点(CTLA4、PD-1及其配体)的作用机制。我们进行了文献检索,并确定了相关的近期临床报告、实验研究和综述文章。本文综述了我们在细胞和分子水平上对CPI作用机制的认识。作者还讨论了如何通过抑制CTLA4, PD-1和PD-L1来重新激活T细胞反应,从而在癌症免疫治疗中用于肿瘤抑制。PD-1和CTLA4阻断的机制以及这些分子的正常生物学功能非常复杂,需要进一步的研究,这对于开发新方法将检查点阻断的益处与导致免疫相关不良事件的免疫再激活的脱靶效应分离开来至关重要。
Treatments with FDA-approved blocking antibodies targeting inhibitory cytotoxic T lymphocyte antigen 4 (CTLA4), programmed cell death protein 1 (PD-1) receptor or the programmed cell death ligand 1 (PD-L1), collectively named checkpoint inhibitors (CPI), have been successful in producing long-lasting remissions, even in patients with advanced stage cancers. However, these treatments are often accompanied by undesirable autoimmune and inflammatory side effects, sometimes bringing severe consequences for the patient. Rapid expansion of clinical applications necessitates a more nuanced understanding of CPI function in health and disease to develop new strategies for minimizing the negative side effects, while preserving the immunotherapeutic benefit. This review summarizes a new paradigm shifting approach to cancer immunotherapy with the focus on the mechanism of action of immune checkpoints (CTLA4, PD-1 and its ligands). We performed a literature search and identified relevant recent clinical reports, experimental research, and review articles. This review highlights our understanding of the CPI mechanism of action on cellular and molecular levels. Authors also discuss how reactivation of T cell responses through the inhibition of CTLA4, PD-1, and PD-L1 is utilized for tumor inhibition in cancer immunotherapy. Mechanisms of PD-1 and CTLA4 blockade and normal biological functions of these molecules are highly complex and require additional studies that will be critical for developing new approaches to dissociate the benefits of checkpoint blockade from off-target effects of the immune reactivation that lead to immune-related adverse events.
T细胞共刺激和共抑制的分子机制。
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